Attachment A - R82 PVQ - (10-27-17 non sub change request)

Preventive Care (PVQ)
Variable Name
MR Screen Name

Question type

BOX PVBEG

routing

PVINTRO

PVINT

No entry

FLUSHOT

PVF1

yes/no

BOX PV1

routing

FLUCODE

PVF2

code all

FLUOTHOS

PVF2

verbatim text

BOX PV2

routing

PVF3

code 1

PVFLU3

Question text/description
Code list
IF RESPONDENT IS DECEASED, GO TO BOX PVEND.
ELSE IF SEASON=FALL, GO TO PV8 - PREVHLTHINTRO.
ELSE IF (SEASON=WINTER), GO TO PVINT-PVINTRO.
ELSE IF (SEASON=SUMMER) AND (WINTER ROUND RESONSE TO PVF1-FLUSHOT^=1/YES), GO TO PVINTPVINTRO.
ELSE IF (SEASON=SUMMER) AND (WINTER ROUND RESONSE TO PVF1-FLUSHOT=1/YES), GO TO BOX PV4.
IF SEASON=WINTER, FILL "Now I’d like to ask you some questions about the seasonal flu vaccine."
ELSE IF SEASON=SUMMER, FILL "At the time of the last interview, we recorded that [you/(SP)] had not gotten
a flu vaccination for the [CURRENT YEAR MINUS 1] - [CURRENT YEAR] flu season."
(01) YES
Since [July 1st, (CURRENT YEAR MINUS 1)/[MREFDATE]], [have you/has (SP)] had a seasonal flu vaccination?
(02) NO
(-8) DON’T KNOW
IF THE RESPONDENT MENTIONS A SHORT NEEDLE OR NEEDLELESS INJECTOR, CODE AS “YES”.
(-9) REFUSED
IF SEASON=WINTER GO TO PVF2-FLUCODE.
ELSE GO TO BOX PV4.
(01) DIDN’T KNOW IT WAS NEEDED
(02) SHOT COULD CAUSE FLU
(03) SHOT COULD HAVE SIDE EFFECTS OR CAUSE
DISEASE
(04) DIDN’T THINK IT WOULD PREVENT THE
FLU/COULD GET THE FLU ANYWAY
(05) FLU NOT SERIOUS/WOULD NOT GET FLU
ANYWAY/NOT AT RISK/NEVER GET THE FLU
(06) DOCTOR DID NOT RECOMMEND THE SHOT
(07) DOCTOR RECOMMENDED AGAINST GETTING
VACCINE
(08) DON'T LIKE SHOTS OR NEEDLES/CONCERNS
ABOUT SORENESS OR RASH/LOCAL REACTIONS
For what reason didn't [you/(SP)] get a seasonal flu vaccination since July 1st?
(09) INCONVENIENT TO GET SHOT/UNABLE TO GET
TO LOCATION
[PROBE: Any other reason?]
(10) DIDN’T THINK ABOUT IT/FORGOT/MISSED IT
CHECK ALL THAT APPLY.
(11) COST OF VACCINE
(12) HAD VACCINE BEFORE/DIDN’T NEED IT AGAIN
(13) VACCINE UNAVAILABLE/VACCINE SHORTAGE
(14) NOT WORTH THE MONEY
(15) DIDN'T HAVE TIME
(16) NOT IN HIGH RISK/PRIORITY GROUP
(17) ONGOING HEALTH CONDITION PREVENTING
VACCINE/ALLERGIC TO SHOT/MEDICAL REASONS
(18) DON'T TRUST WHAT GOVERNMENT SAYS ABOUT
VACCINE
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED
OTHER (SPECIFY)
IF MORE THAN ONE RESPONSE SELECTED AS YES AT PVF2-FLUCODE, GO TO PVF3-PVFLU3, ELSE GO TO BOX
PV3
[LIST ALL RESPONSES SELECTED AT PVF2-FLUCODE]
Of the reasons you listed, what is the main reason [you/(SP)] did not get a flu vaccination this flu season?
_ _ [ENTER MAIN REASON]
(-8) DON’T KNOW
READ LIST TO RESPONDENT. IF RESPONDENT SELECTS MORE THAN ONE REASON PROBE FOR MAIN REASON.
(-9) REFUSED

Preventive Care (PVQ)
Variable Name
MR Screen Name
BOX PV3

Question type
routing

NOVACINE

PVF4

yes/no

VACSUPLY

PVF5

yes/no

BOX PV4

routing

SHINGVAC

PV6

yes/no

BOX PV5

routing

PNEUSHOT

PV7

yes/no

PREVHLTHINTRO

PV8

no entry

BPTAKEN

PV9

code one

BCTAKEN

PV10

code one

BOX PV19

Question text/description
IF RESPONSE TO PVF2-FLUCODE DOES NOT INCLUDE 13, GO TO PVF4-NOVACINE.
ELSE GO TO BOX PV4.

Code list

(01) YES
Was one reason that [you/(SP)] did not get a seasonal flu vaccination since July 1st, [CURRENT YEAR MINUS 1] (02) NO
because the vaccine was in short supply or unavailable?
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
Did [you/(SP)] have any trouble getting a seasonal flu shot when (you/he/she) wanted to because the vaccine (02) NO
was in short supply or unavailable?
(-8) DON'T KNOW
(-9) REFUSED
IF THIS IS A SUMMER ROUND AND RESPONDENT HAS NOT REPORTED RECEIVING THE SHINGLES VACCINE
(P_SHINGVAC^=1) AND RESPONDENT IS AGE 60 OR ABOVE (AGECALC ≥ 60), GO TO PV6-SHINGVAC.
ELSE GO TO BOX PV5.
Shingles is an outbreak of a rash or blisters on the skin that may be associated with severe pain. The pain is
generally on one side of the body or face. Shingles is caused by the chicken pox virus. A vaccine for shingles
has been available since May 2006.

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

[Have you/Has (SP)] ever had the Zoster (ZOSS-ter) or Shingles vaccine, also called Zostavax®?
IF THIS IS A SUMMER ROUND AND RESPONDENT HAS NOT REPORTED RECEIVING THE PNEUMONIA VACCINE
(PNEUSHOT^=1), GO TO PV7-PNEUSHOT.
ELSE GO TO BOX PVEND.
[Have you/Has (SP)] EVER had a pneumonia shot?
(01) YES
(02) NO
This shot is usually given only once or twice in a person's lifetime and is different from the flu shot. It is also (-8) DON'T KNOW
called the pneumococcal vaccine.
(-9) REFUSED
(01) CONTINUE
These next few questions are about preventive health care measures some people take.
(-7) EMPTY
(01) LESS THAN 6 MONTHS AGO
(02) 6 MONTHS TO LESS THAN 1 YEAR AGO
(03) 1 YEAR TO LESS THAN 2 YEARS AGO
When was the most recent time [you/(SP)] had [your/his/her] blood pressure taken by a doctor or other
(04) 2 YEARS AGO TO LESS THAN 5 YEARS AGO
health professional?
(05) 5 OR MORE YEARS AGO
(06) NEVER HAD BLOOD PRESSURE TAKEN
(-8) DON'T KNOW
(-9) REFUSED
(01) LESS THAN 6 MONTHS AGO
(02) 6 MONTHS TO LESS THAN 1 YEAR AGO
(03) 1 YEAR TO LESS THAN 2 YEARS AGO
(04) 2 YEARS AGO TO LESS THAN 5 YEARS AGO
When was the most recent time [you/(SP)] had [your/his/her] cholesterol checked?
(05) 5 OR MORE YEARS AGO
(06) NEVER HAD CHOLESTEROL CHECKED
(-8) DON'T KNOW
(-9) REFUSED
IF ROUND= FALL 2018 ROUND 82, GO TO PV19-BTSTHIV.
ELSE IF SP IS IN THE BASELINE INTERIVEW (sample_person.INTTYPE=3) GO TO PV19-BTSTHIV. IF P_EVRHIV=0
THEN GO TO PV20-CTSTHIV. ELSE GO TO BOX PV6.

Preventive Care (PVQ)
Variable Name
MR Screen Name

BTSTHIV

CTSTHIV

RCNTHIV

PV19

PV20

PV21

Question type

Question text/description

Code list

yes/no

The next question is about the test for HIV, the virus that causes AIDS. Except for tests [you/(SP)] may have
had as part of blood donations, have [you/he/she] ever been tested for HIV?

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

code one

The next question is about the test for HIV, the virus that causes AIDS. Except for tests [you/(SP)] may have
had as part of blood donations, since (SAMPLE_PERSON.DATE_FALLRND) have [you/he/she] been tested for
HIV?

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

When did [you/(SP)] have [your/his/her] most recent HIV test?

(01) LESS THAN 6 MONTHS AGO
(02) 6 MONTHS TO LESS THAN 1 YEAR AGO
(03) 1 YEAR TO LESS THAN 2 YEARS AGO
(04) 2 YEARS AGO TO LESS THAN 5 YEARS AGO
(05) 5 OR MORE YEARS AGO
(06) NEVER HAD HIV TEST
(-8) DON'T KNOW
(-9) REFUSED

code one

Preventive Care (PVQ)
Variable Name
MR Screen Name

WHYNHIV

MAMMOGRM

Question type

Question text/description

PV22

code one

(01) IT’S UNLIKELY YOU’VE BEEN EXPOSED TO HIV
(02) YOU WERE AFRAID TO FIND OUT IF YOU WERE
HIV POSITIVE (THAT YOU HAD HIV)
(03) DR. DID NOT PRESCRIBE OR RECOMMEND IT
(04) YOU DIDN’T WANT TO THINK ABOUT HIV OR
ABOUT BEING HIV POSITIVE
(05) YOU WERE WORRIED YOUR NAME WOULD BE
REPORTED TO THE GOVERNMENT IF YOU TESTED
I am going to show you a list of reasons why some people have not been tested for HIV (the virus that causes POSITIVE
AIDS). Which one of these would you say is the MAIN reason why [you/(SP)] have not been tested?
(06) YOU DIDN’T KNOW WHERE TO GET TESTED
(07) YOU DON’T LIKE NEEDLES
(08) YOU WERE AFRAID OF LOSING JOB, INSURANCE,
HOUSING, FRIENDS, FAMILY, IF PEOPLE KNEW YOU
WERE POSITIVE FOR AIDS INFECTION
(09) SOME OTHER REASON
(10) NO PARTICULAR REASON
(-8) REFUSED
(-9) DON’T KNOW

BOX PV6

routing

IF SP IS FEMALE, GO TO PV11 - MAMMOGRM.
ELSE GO TO BOX PV8.

PV11

yes/no

[Have you/Has (SP)] had a mammogram or a breast X-ray since (SAMPLE_PERSON.DATE_FALLRND)?

Code list

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

Preventive Care (PVQ)
Variable Name
MR Screen Name

Question type

Question text/description

Code list
(01) DIDN’T KNOW IT WAS NEEDED/NO
NEED/NOTHING WRONG
(02) NOT RECOMMENDED EVERY YEAR/ON A
DIFFERENT SCREENING SCHEDULE
(03) DIDN’T THINK IT WOULD PREVENT BREAST
CANCER/COULD GET BREAST CANCER ANYWAY/TEST
IS USELESS
(04) NOT AT RISK FOR BREAST CANCER
(05) DOCTOR DID NOT PRESCRIBE OR RECOMMEND IT
(06) DOCTOR RECOMMENDED AGAINST GETTING IT
(07) DON’T LIKE MAMMOGRAMS/PAIN, SORENESS,
DISCOMFORT OR REACTIONS
(08) INCONVENIENT/UNABLE TO GET TO
LOCATION/TRANSPORTATION DIFFICULTY
(09) DIDN’T THINK ABOUT IT/FORGOT/MISSED
IT/PROCRASTINATED
(10) COST OF MAMMOGRAM/INSURANCE DOESN’T
COVER COST/NOT WORTH THE MONEY
(11) AFRAID OF RESULTS/DON’T WANT TO KNOW
(12) MAMMOGRAM RADIATION COULD CAUSE
CANCER/ILL EFFECTS
(13) NEVER HEARD OF MAMMOGRAM
(14) APPOINTMENT SCHEDULED FOR FUTURE DATE
(15) MASTECTOMY/BREASTS REMOVED
(16) TOO ILL, PHYSICALLY/MENTALLY
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

MAMCODE

PV11

code all

What is the reason that [you have/(SP) has] not had a mammogram since
((SAMPLE_PERSON.DATE_FALLRND)?
CHECK ALL THAT APPLY.

MAMNOTHS

PV11

verbatim text

OTHER (SPECIFY)

PAPSMEAR

PV12

yes/no

[Have you/Has (SP)] had a Pap smear test since ((SAMPLE_PERSON.DATE_FALLRND)?

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

Preventive Care (PVQ)
Variable Name
MR Screen Name

Question type

Question text/description

PAPCODE

PV13

code all

What is the reason that [you have/(SP) has] not had a Pap smear test since
((SAMPLE_PERSON.DATE_FALLRND)?
CHECK ALL THAT APPLY.

PAPNOTHS

PV13

verbatim text

OTHER (SPECIFY)

BOX PV7

routing

IF RESPONDENT HAS NOT PREVIOUSLY REPORTED HYSTERECTOMY (SAMPLE_PERSON.P_HYSTEREC^=1) AND
RESPONSE TO PV13 – PAPCODE DOES NOT INCLUDE 14/HadHysterectomy, GO TO PV14 - HYSTEREC.
ELSE GO TO BOX PVEND.

HYSTEREC

PV14

BOX PV8

PROSSURG

PV15

yes/no

routing

yes/no

[Have you/Has (SP)] ever had a hysterectomy?
IF SP HAS EVER REPORTED HAVING PROSTATE SURGERY IN A PREVIOUS ROUND
(sample_person.P_PROSSURG=1), GO TO PV16 - DIGTEXAM.
ELSE GO TO PV15 - PROSSURG.
[Since (SAMPLE_PERSON.DATE_FALLRND), [have you/has (SP)/[Have you/has (SP)] ever] had surgery on
(your/his) prostate?

Code list
(01) DIDN’T KNOW IT WAS NEEDED/NO
NEED/NOTHING WRONG
(02) NOT RECOMMENDED EVERY YEAR/ON A
DIFFERENT SCREENING SCHEDULE
(03) DIDN’T THINK IT WOULD PREVENT
CANCER/COULD GET CANCER ANYWAY/TEST IS
USELESS
(04) NOT AT RISK FOR CANCER
(05) DOCTOR DID NOT PRESCRIBE OR RECOMMEND IT
(06) DOCTOR RECOMMENDED AGAINST GETTING IT
(07) DON’T LIKE PAP SMEAR/PAIN, SORENESS,
DISCOMFORT OR REACTIONS
(08) INCONVENIENT/UNABLE TO GET TO
LOCATION/TRANSPORTATION DIFFICULTY
(09) DIDN’T THINK ABOUT IT/FORGOT/MISSED
IT/PROCRASTINATED
(10) COST OF PAP SMEAR/INSURANCE DOESN’T
COVER COST/NOT WORTH THE MONEY
(11) AFRAID OF RESULTS/DON’T WANT TO KNOW
(12) NEVER HEARD OF PAP SMEAR
(13) APPOINTMENT SCHEDULED FOR FUTURE DATE
(14) HAD HYSTERECTOMY/NO UTERUS, OVARIES
(15) TOO ILL, PHYSICALLY/MENTALLY
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

(01) YES
(02) NO
(-8) DON'T KNOW
[EXPLAIN IF NECESSARY: Surgery on the prostate gland is typically used as a treatment for prostate cancer or
(-9) REFUSED
to correct urinary problems. Surgery can include complete or partial removal of the prostate.]

Preventive Care (PVQ)
Variable Name
MR Screen Name

DIGTEXAM

PV16

Question type

yes/no

Question text/description
[These next few questions are about follow-up care sometimes prescribed after prostate surgery].
[Have you/Has (SP)] had a digital rectal examination (of the prostate) since
(SAMPLE_PERSON.DATE_FALLRND)?
[EXPLAIN IF NECESSARY: The exam may be used to detect prostate cancer, to determine whether cancer has
spread beyond the prostate, and as part of follow-up care after prostate surgery.]
[Have you/Has (SP)] had a blood test for detection of prostate cancer, known as a PSA, since
(SAMPLE_PERSON.DATE_FALLRND)?

BLOODTST

PV17

yes/no

PSA = PROSTATE-SPECIFIC ANTIGEN
[EXPLAIN IF NECESSARY: The test may be used to detect prostate cancer, to determine whether cancer has
spread beyond the prostate, and as part of follow-up care after prostate surgery.]

PRONCODE

PV18

code all

What is the reason that [you have/(SP) has] not had a prostate blood test or PSA since
(SAMPLE_PERSON.DATE_FALLRND)?
CHECK ALL THAT APPLY.

PRONOTHS

PV18

verbatim text

OTHER (SPECIFY)

Code list
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

(01) DIDN’T KNOW IT WAS NEEDED/NO
NEED/NOTHING WRONG
(02) NOT RECOMMENDED EVERY YEAR/ON A
DIFFERENT SCREENING SCHEDULE
(03) DIDN’T THINK IT WOULD PREVENT
CANCER/COULD GET CANCER ANYWAY/TEST IS
USELESS
(04) NOT AT RISK FOR CANCER
(05) DOCTOR DID NOT PRESCRIBE OR RECOMMEND IT
(06) DOCTOR RECOMMENDED AGAINST GETTING IT
(07) DON’T LIKE BLOOD TESTS/PAIN, SORENESS,
DISCOMFORT OR REACTIONS
(08) INCONVENIENT/UNABLE TO GET TO
LOCATION/TRANSPORTATION DIFFICULTY
(09) DIDN’T THINK ABOUT IT/FORGOT/MISSED
IT/PROCRASTINATED
(10) COST OF TEST/INSURANCE DOESN’T COVER
COST/NOT WORTH THE MONEY
(11) AFRAID OF RESULTS/DON’T WANT TO KNOW
(12) NEVER HEARD OF PSA
(13) APPOINTMENT SCHEDULED FOR FUTURE DATE
(14) PROSTATECTOMY/PROSTATE REMOVED
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED